Healthcare Plans We Offer
We offer Medi-Cal, AIM, Healthy Kids, Healthy Families, Medicare, Family PACT, CHDP (Child Health and Disability Prevention), and Healthy Way LA Matched and Unmatched healthcare plans. We also accept private insurance, credit cards, and cash payments for all services provided. Call Managed Care Operations at (213) 747-5542, ext. 3202 to go over the programs offered and discuss the eligibility requirements that you meet. If your plan of choice is not listed, please call to find out if we accept it.
Eisner Pediatric & Family Medical Center is an official Medi-Cal Outreach site. We have an on-site Los Angeles County Medi-Cal worker and Certified Application Assistors (CAA) to help you with your Medi-Cal needs. Medi-Cal is California’s Medicaid healthcare program. It pays for a variety of medical services for children and adults who have limited income. The program offers many options for coverage:
- If you meet the age, residency, and income requirements, you may be eligible to receive FULL Medi-Cal coverage at no cost. Your children may be eligible for coverage even if you are not.
- If your income exceeds the allowed level, you may still be eligible for Medi-Cal, but you will have to pay a share of the cost whenever you receive services. Your share of cost is based on your income and family size.
- If you do not meet the residency requirement, you may still be eligible for Emergency Medi-Cal coverage.
- If you are pregnant, you may receive temporary Medi-Cal services for pregnancy right away under a program called Presumptive Eligibility for Pregnant Women. Under Deemed Eligibility, your baby is automatically eligible for Medi-Cal coverage for newborns for the first year of his or her life. This coverage is good as long as you are eligible for Medi-Cal when you deliver.
- In most cases, your Medi-Cal will require you to choose a health plan in which you select your doctor of choice. You may choose from a number of participating health plans, which include LA Care, Care 1st, Community Health Plan, Anthem Blue Cross, Health Net, and Molina.
AIM (Access for Infants and Mothers)
If your income is too high for free Medi-Cal, you may qualify for AIM. This is a low-cost program for uninsured pregnant women. You must be no more than 30 weeks into your pregnancy and a California resident. AIM covers your prenatal care and delivery. Your coverage continues for 60 days after you give birth. When your baby is born, he or she will be enrolled automatically into the Healthy Families program. This will cover all medically necessary health, dental, and vision services for your baby.
Healthy Kids offers low-cost health coverage for children under age 19 who don’t qualify for Medi-Cal or Healthy Families. Enrollment for children ages 6 to 18 is closed currently. Healthy Kids is administered by LA Care Health Plan.
Healthy Families is low-cost insurance that provides health, dental, and vision coverage to children who do not have insurance and do not qualify for no-cost Medi-Cal. If your child currently has Medi-Cal coverage that is ending because your family income is over the limit, you can apply for Healthy Families coverage up to 3 months before Medi-Cal ends.
Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age with permanent kidney failure (called “End-Stage Renal Disease”). You must be a U.S. citizen or have entered legally and lived here 5 years to be eligible for Medicare. You have the option to be enrolled in a senior advantage plan. Available plans through EPFMC include Molina Options Plus, SCAN Senior Advantage Plan, Care 1st Senior Advantage Plan, LA Care Senior Advantage Plan, and Health Net Senior Advantage Plan.
Family PACT Pays for Family Planning Services
Family PACT is a program that provides no-cost family planning services to low-income men, women, and teens. Anyone able to become pregnant or get someone else pregnant may qualify for Family PACT services. You must meet income guidelines and be a California resident. You may qualify if you have:
- No medical insurance or can’t get Medi-Cal
- Insurance that does not cover family planning or birth control
- Insurance with a deductible that you have not met
- Medi-Cal with a share-of-cost pay requirement that you have not met
- Medi-Cal that does not cover family planning
- Insurance or Medi-Cal but you need to keep family planning services confidential
Child Health and Disability Prevention Program (CHDP)
This program provides free preventive health checkups for infants, children, teens, and young adults in low-income families. CDHP pays for pediatric and adolescent physical exams. California requires all children to have a physical before entering the first grade. CHDP benefits include:
- Lead testing
- TB screening
- Health education
- Dental screening and referral
- Nutrition evaluation
- Behavioral evaluation
CHDP further assists families with referrals to the WIC (Women, Infants, and Children) nutritional care program for children under 5, scheduling medical appointments, getting transportation, and accessing diagnostic and treatment services. A WIC office is now located inside the EPFMC building.
CDHP Gateway is an enrollment process that allows families to temporarily enroll their children into Medi-Cal through an online automated system. This enrollment process occurs when parents take their children to a CHDP provider for a physical examination. Eligible children will receive temporary full Fee-for-Service Medi-Cal coverage. Families must complete a Medi-Cal/Healthy Families application to continue receiving healthcare coverage.
Children enrolled in temporary Medi-Cal through the CHDP Gateway Enrollment Process receive:
- The same benefits they would under regular no-cost Medi-Cal
- A temporary Medi-Cal card (BIC-Benefits Identification Card) in the mail
- Access to Medi-Cal services on a fee-for-service basis during the temporary eligibility period
Families can go to any provider who takes Fee-for-Service Medi-Cal (including EPFMC) for their children’s medical care. You do not pay anything for the medical services your children receive.
Contact Managed Care Operations at (213) 747-5542, ext. 3202 for help in sorting out the programs you are eligible for and completing the application.
Eligibility & Enrollment Help
|Your Medi-Cal Enrollment Appointment
Find out what you need to bring to your appointment. More >
|Are You Eligible for These Plans?
Compare the eligibility requirements for the healthcare plans we offer.